Targeted Alpha Therapy with 225Actinium-Prostate Specific Membrane Antigen (PSMA)-I&T of Castration-resISTant Prostate Cancer (TATCIST).

  • Active Not Recruiting
  • Treatment
  • Interventional
  • Drug
  • PHASE2
  • Fusion Pharmaceuticals Inc.
  • 18 Years -


Study Purpose

The treatment regimen will consist of 4 doses of FPI-2265

Intervention

Drug : FPI-2265


Eligibility Requirements

info icon Participants aged ≥ 18 years.

info icon Participants must have the ability to understand and sign an approved informed consent (ICF).

info icon Participants must have the ability to understand and comply with all protocol requirements.

info icon Adenocarcinoma of prostate proven by histopathology.

info icon Life expectancy of 6 months or more.

info icon Unresectable metastases.

info icon Documented progressive disease (PD); progressive mCRPC will be based on at least 1 of the following criteria: 1. Serum PSA progression is defined as 2 consecutive increases in PSA over a previous reference value measured at least 1 week prior. The minimal starting value is 1.0 ng/mL, if PSA is the only indication of progression. 2. Soft-tissue progression defined as an increase ≥ 20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or more new lesions. 3. Progression of bone disease: evaluable disease or new bone lesions(s) by bone scan (2+2 PCWG3 criteria).

info icon If known Breast Cancer gene (BRCA) mutations are present, participants should have received FDA approved therapies such as poly-ADP ribose polymerase (PARP) inhibitors and progressed.

info icon Castration resistant disease with confirmed testosterone level ≤ 50 ng/dL under prior androgen deprivation therapy (ADT). Must have a castrate level of serum testosterone (\< 50 ng/dL or \< 1.7 nmol/L).

info icon Positive PSMA PET/CT scans, obtained with approved PSMA-ligands, defined as at least one PSMA-positive metastatic lesion and no PSMA-negative lesions.

info icon ECOG-PS 0 to 1.

info icon Hemoglobin (Hgb) concentration ≥ 9.0 g/dL.

info icon Platelet counts ≥ 100 × 10\^9/L.

info icon White blood cell (WBC) count ≥ 2.0 × 10\^9/L, absolute neutrophil count (ANC) \> 1.5 × 10\^9/L.

info icon a. Hematological criteria cannot be met with ongoing or recent blood transfusions (within 7 days prior to the scheduled first dose of study treatment) or require growth factor support (within 21 days prior to the scheduled first dose of study treatment).

info icon Alanine aminotransferase or aspartate aminotransferase ≤ 3.0 × upper limit of normal (ULN).

info icon Serum total bilirubin ≤ 1.5 × ULN; in participants with Gilbert's syndrome, a total bilirubin ≤ 3 times ULN and direct bilirubin within normal limits are permitted.

info icon Albumin ≥ 2.5 g/dL.

info icon Serum/plasma creatinine ≤ 1.5 × ULN or creatinine clearance ≥ 60 mL/min based on the Cockcroft-Gault formula.

info icon Prothrombin time, international normalized ratio or prothrombin time test \< 1.5 × ULN.

info icon Received ≥ 1 androgen receptor axis-targeted therapies (ARAT).

info icon Participants on anti-androgen therapy are allowed to continue their treatment at the discretion of their treating physician.

info icon Minimum age: 18

info icon Less than 6 weeks from enrollment since last myelosuppressive therapy (including Docetaxel, Cabazitaxel, 223Ra, 153Sm, 177Lu-PSMA-617/other Lu-PSMA RLT or any other radionuclide therapy). Participants who received previous treatment with Ac-225 are excluded.

info icon Participants who received more than 4 prior lines of systemic therapy for CRPC.

info icon Urinary tract obstruction as evidenced by Tc-99m DTPA renal scan with diuretics.

info icon Participants with skeletal metastases presenting as a superscan on a 99m Tc MDP Bone Scan.

info icon Superscan is defined as a bone scan which demonstrates markedly increased skeletal radioisotope uptake relative to soft tissues in association with absent or faint renal activity (absent kidney sign).

info icon Persistent baseline dry eye or dry mouth \> Grade 1 from prior RLT.

info icon Persistent prior AEs \> Grade 1 from prior anti-cancer therapies.

info icon Abnormal renal function (estimated glomerular filtration rate \< 60 mL/min), baseline Hgb \< 9g/dL, ANC \< 1.5 ×10\^9/L, platelets \< 100 ×10\^9/L, and prothrombin time, international normalized ratio or prothrombin time test ≥ 1.5 × ULN.

info icon Administration of an investigational agent ≤ 60 days or 5 half-lives, whichever is shorter, prior to Cycle 1, Week 0.

info icon Known presence of central nervous system (CNS) metastases or liver metastases.

info icon Active malignancy other than low-grade non-muscle-invasive bladder cancer and non-melanoma skin cancer.

info icon Concurrent illness that may jeopardize the participant's ability to undergo study procedures as determined by the Investigator.

info icon Symptomatic cord compression, or clinical or radiologic findings indicative of impending cord compression.

info icon Concurrent serious (as determined by the investigator) medical conditions, including, but not limited to, New York Heart Association Class III or IV congestive heart failure, unstable ischemia, uncontrolled symptomatic arrhythmia, history of congenital prolonged QT syndrome, uncontrolled infection, known active hepatitis B or C, or other significant co-morbid conditions that in the opinion of the Investigator would impair study participation or cooperation.

info icon Major surgery ≤ 30 days prior to enrollment.

info icon Planning to conceive pregnancy during the treatment and up to 6 months after the last treatment.

Recruiting status

Active Not Recruiting

Estimated enrollment

115

 
Study start date

Dec 16, 2021

Study end date

Jul 31, 2025

Last updated

Mar 23, 2025

Primary purpose

Treatment

Design

Interventional

Intervention

Drug

Study phase

PHASE2

Allocation

Na

 

Sponsor:

Fusion Pharmaceuticals Inc.

Collaborator:

N/A

Investigator:

Keith Barnett

NCT05219500

Clinic Location Investigator Distance RECRUITING STATUS Contact